Os sentidos do adoecimento pelo câncer colorretal: estudo etnográfico

Abstract

Colorectal neoplasms affect the colon and rectum causing changes in intestinal habit, anemia, fatigue, rectal bleeding, obstruction, among others. According to the National Cancer Institute, the diagnosis of 17,380 new cases of colon and rectum cancer in men and 18,980 in women is expected in 2018/2019 for each year, approximately 190 cases will be diagnosed among men and 310 among women in the state of Pará making 500 cases, of these 240 will occur in the capital of Belém. The surgical treatment makes a new path for fecal elimination (estomy), the colostomy to be performed in the large intestine or the ileostomy to be performed in the small intestine temporarily or permanently. The purpose of this study was to interpret the meanings attributed by people to the experience of colorectal cancer and surgical treatment with stomization. This is an ethnographic study supported by the sociology of health in the oncological surgical clinic of the Ophir Loyola Hospital and the Chemotherapy Outpatient Clinic in Belém between August 2018 and February 2019, with companions and patients suffering from colorectal cancer. It counted on the techniques of participant observation, non­participant, field diary and semi­structured interview in depth of the interpretative type, structuring from the narratives of the deponent and subsequent thematic analysis of Braun and Clarke. Fourteen patients were studied, and the caregivers were joined by twenty­two people, namely: eight sick­couple companions (sixteen people) and contacts with six sick people who felt comfortable answering the interview questions without assistance at the end. The senses were seized from a sample that in its totality used only the SUS public service, seven men and seven women, mostly pardos, studied until elementary school and possessed up to 1 minimum wage on average. As results, nine senses were obtained: (1) The history of sickness interrupted by difficulties; (2) Impressions on the public health service; (3) Estomization: future needs and paradoxical feelings towards "socializing"; (4) Losses in the patience­resilience process; (5) Corrected, fortified and constructed bonds: care as a fundamental coefficient; (6) Opinions about nursing; (7) Social­religious and spiritual behavior; (8) Behavioral etiologies that trigger colorectal cancer, traditional knowledge and forms of treatment; (9) The immediate dream and the future prospects; being categorized into four units: Accessibility to SUS; Estomization: duality of experiences; The strategy of coping with the relationship with Nursing professionals; Socio­religious­spiritual repercussions of colorectal cancer stomization and future expectations. The senses of the experience of being stomped are ambiguous in the postoperative, converging to new ways of socializing, seeking resilience and future perspectives of life. It is noted that the symptoms and the intricate pathway in primary care were intervening factors for discrediting the public health service, however, the built links, the nursing care and the religious faith were factors referenced as beneficial in this course.